Covid Scotland: Modellers caution of uncertainty over virus trends in months ahead

The Modelling the Epidemic report states: “The timing is uncertain but has currently been lined up with the summer holidays where reduced travel restrictions may make it more likely that a new variant is brought into Scotland.”

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The authors stress that these are “plausible scenarios” but “should not be considered predictions”, adding: “It is difficult to ascertain which of these scenarios may be the more likely and in reality the situation is likely to move from one to the other and not in a linear fashion.”

It comes amid uncertainty over whether Scotland’s virus rates are increasing, decreasing, or levelling off.

The Office for National Statistics estimates from its surveillance that one in 12 people in Scotland had Covid in the week ending March 26, down from one in 11 the previous week, but said the “trend was uncertain”.

Wastewater monitoring in Scotland detected an increase in virus levels of nearly 50% in the week ending March 29, compared to the previous seven days.

The number of people in hospital with Covid rose to 2,383 - equalling the previous record set on Tuesday, and reversing previous signs of a decline.

Mass testing for the general population in Scotland will be wound down from April 18, the same date that facemasks are due to become guidance rather than law.

The Modelling the Epidemic report outlines five possible scenarios for the months ahead.

One envisions Omicron remaining dominant, with vaccines and natural immunity holding up so that “infections may decrease from current levels over the coming weeks and months to very low levels”. Covid becomes endemic and cases “spring up only as rare outbreaks”.

In a second scenario, waning immunity and “the increasing reluctance of people in Scotland to keep being boosted" erodes population protection.

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The number of people requiring medical treatment or hospitalisation for Covid “rises particularly in vulnerable/older age groups”, the NHS finds it harder to focus on recovery, and society “becomes segmented” as those at highest risk “lead restricted lives or accept significant risk of serious illness” while “the rest of the population live a more normal life accepting the possibility of infection with mild illness”.

A third scenario also describes a society “polarised as some continue to take up vaccines and follow guidance while others are more reluctant”.

Covid cases “spring up and are hard to control in those who are not vaccinated or vulnerable” and “the very elderly and immune compromised are at risk from infection from those not vaccinated or boosted”.

The scenarios range from 'Immune World' where infections and hospitalisations fall to very low levels through summer, and a scenario where summer holidays result in the spread of a dangerous new variant leading to very high hospital demand

The final two scenarios involve variants.

In the first, a variant with increased transmission but not increased severity emerges resulting in a scenario “similar to what has happened in Scotland with the emergence of Omicron”.

In the final scenario “a new variant appears in Scotland as people return from their summer holidays and return to work and school”. This has similar transmissibility and immune escape to Omicron, but replaces it and also causes more severe disease than the previous Delta strain.

The report adds: “It could lead to high levels of infections leading to hospital occupancy rising well above capacity restrictions. With sustained high levels of infection we could again see increased staff absences in a number of sectors that were affected by this in the recent Omicron wave.”